AIDS virus emerges as the leading killer of city's young adults

March 03, 1991|By Jonathan Bor

For the first time since the epidemic surfaced, AIDS in 1989 became the leading killer of Baltimore's young adults.

Statistics compiled recently by the Baltimore City Health Department reveal that infections caused by the AIDS virus accounted for 14.1 percent of deaths to city residents between the ages of 25 and 44 -- surpassing homicides and heart disease, which ranked second and third. The rankings for 1990 have not yet been completed.

"We're going to see increases all the way through the mid-1990s easily in terms of the number of people dying from AIDS," said Arthur Cohen, AIDS program manager for the city Health Department. "I'm concerned about the impact on local medical institutions. We're not geared up to serve the number of people dying."

In the face of a mounting death toll, he said, the Chase-Brexton Clinic and three hospitals -- Johns Hopkins, University and Sinai -- continue to shoulder the burden of caring for the great majority of AIDS cases.

"There's still a lot of dumping to the two or three major hospitals providing this care," he said.

Mr. Cohen said other hospitals and clinics will have to join the battle for the increasing numbers of sick people to get the care they need.

While several experts said they were not surprised by the statistics -- bulging hospital caseloads provide daily evidence -- they said the statistics carried the important message that acquired immune deficiency syndrome has become a leading killer among whites and blacks, and men and women.

In the 25-44 age bracket, infections caused by the human immunodeficiency virus, or HIV, were the leading cause of death when all sex and racial groups were combined.

It led among three demographic groups -- black people in general, white men and black men -- and was the second leading killer among two groups: white people in general and black women.

The statistics were compiled by John Sweitzer and Thomas McArdell of the Health Department's preventive medicine division.

Mr. Cohen said the statistical breakdown shows in stark detail the way AIDS, which struck white men most heavily when it surfaced a decade ago, has crossed race and gender lines in the ensuing years. Also, the 1989 death toll also means that transmission was occurring rapidly across these groups many years earlier.

The AIDS virus is believed to have an average incubation period of 11 years -- meaning it takes that long, on average, for the virus to cause the full-blown disease.

Mr. Cohen said he hoped the rankings -- although grim -- would counter any complacency that followed the state health department's new estimate of the number of Mary

landers infected with HIV. In January, state health officials estimated that the number was somewhere between 16,000 and 28,000 -- not 60,000 as previously projected.

"I'm not commenting on the accuracy of what they said," Mr. Cohen said. Rather, he said he was afraid that the public might interpret the new estimates to mean that the problem is not a serious one.

"I would say, within the general public and even within the medical professions, there is still a lot of denial going on."

Nationally, by 1988, AIDS was the third leading cause of death in men aged 25 to 44 and the following year, it had reached No. 2, surpassing heart disease, cancer, suicide and homicide. Among women, AIDS was eighth in 1988, and by this year is expected to climb to the top five, according to the federal Centers for Disease Control.

Leading causes of death in Baltimore (1989)

In 1989, for the first time, AIDS virus infection became the leading cause of death among people aged 25 to 44.